To explore the curative effect of lateral lymph node dissection (LLND) through fascia-oriented anatomical approach in male patients with rectal cancer during total mesorectal excision (TME).

A total of 80 male patients with rectal cancer treated in General Hospital of The PLA Southern Theater Command were enrolled between January 2017 and June 2020. According to different intentions, they were divided into control group (38 cases, LLND through vessel-oriented anatomical approach) and observation group (42 cases, LLND through fascia-oriented anatomical approach). The surgical related indexes, postoperative recovery, postoperative function abnormalities and postoperative complications were compared between the two groups. All underwent regular follow-up after discharge. Before surgery, at 1 month, 3 months and 6 months after surgery, quality of life was evaluated by the Europe Organization for Research and Treatment of Cancer quality of life questionaire-colorectal 38 (EORTC QLQ-CR38). The postoperative progression-free survival rates in both groups were analyzed.

There was no significant difference in operation time or intraoperative blood loss between the two groups (P>0.05). The number of dissected lymph nodes in observation group was more than that in control group (P<0.05). There was no significant difference in first ventilation time, leaving bed time or hospitalization time between the two groups (P>0.05). There was no significant difference in the incidence of postoperative complications (abdominal infection, anastomotic fistula, urinary retention, urinary duct injury, incision infection) between the two groups (P>0.05). There was no significant difference in the incidence of urinary dysfunction and sexual dysfunction between the two groups (P>0.05). At 3 and 6 months after surgery, EORTC QLQ-CR38 scores in observation group were higher than those in control group (P<0.05), and postoperative progression-free survival rate was slightly higher than that in control group (P<0.05).

The application effect of LLND through fascia-oriented anatomical approach is significant for male patients with rectal cancer during TME, which can increase number of dissected lymph nodes and prolong postoperative survival.